GI anatomy all Flashcards
1
Q
where does the stomach lie
A
epigastric region
2
Q
where does the jejunum lie
A
the umbilical and left lumbar region
3
Q
where does the ileum lie
A
the hypogastrium and pelvic region
4
Q
where does the caecum and appendix lie
A
right iliac
5
Q
where does the ascending colon lei
A
right inguinal> right lumbar
6
Q
where does the transverse colon lie
A
the umbilical
7
Q
where does the descending colon lie
A
left lumbar> left inguinal
8
Q
where does the sigmoid colon lie
A
the left iliac
9
Q
where does the liver lie
A
epigastric
10
Q
where does the pancreas lie
A
umbilical. tail enters the left hypochondrium
11
Q
where does the spleen lie
A
left hypochondrium
12
Q
what are the nine regions of the abdomen
A
right hypochondrium, epigastric, left hypochondrium
right lumbar, umbilical, left lumbar
right iliac, hypogastrium, left iliac
13
Q
role external oblique
A
compress abdominal viscera, flex trunk, contralateral rotation
14
Q
order of abdominal muscles
A
external oblique> internal oblique> TA
15
Q
role of internal oblique
A
ipsilateral rotation, bilateral contraction
16
Q
role of transversus abdominis
A
compress abdominal contents
17
Q
innervation of the anterolateral abdominal muscles
A
anterior rami t7-t12
IO and TA also have L1
18
Q
what are the anterolateral muscles
A
TA, EO, IO
19
Q
what are the vertical muscles
A
rectus abdomonis
20
Q
role rectus abdomonis
A
stabilises pelvis during walking, depresses ribs
21
Q
what forms the rectus sheath- anterior and posterior walls
A
formed by aponeuroses of the three flat muscles, encloses the RA.
anterior wall- EO, half of IO
posterior wall- half of IO, TA
22
Q
what happens halfway between umbilicus and pubic symphysis
A
the aponeuroses move to the anterior wall of rectus sheath. no posterior wall- RA touches transversalis fascia
23
Q
where is parietal vs visceral peritoneum derived from
A
parietal- somatic. pain is localised
visceral- splanchnic. pain is poorly localised
24
Q
what are the retroperitoneal organs
A
SAD PUCKER
suprarenal glands
aorta
duodenum (apart from proximal 1/3)
panceras ureters colon kidneys oesophagus rectum
25
what is a mesentry
double fold of peritoneum
26
which mesentry gives the liver and spleen
ventral- liver
| dorsal- spleen
27
what is the falciform ligament
connects anterior liver to ventral wall of abdomen. remnant of ventral mesentry
28
what is the lesser omentum
connection between liver and stomach. originates from ventral mesentry
29
what is the gastro colic ligament
part of greater omentum that connects the greater curvature of the stomach to the transverse colon. It forms part of the anterior wall of the lesser sac. dorsal mesentry remnant
30
what is the gastrosplenic ligament
connects stomach and spleen. remnant of dorsal mesentry
31
what is the splenorenal ligament
connects spleen to posterior abdominal wall. remnant of dorsal mesentry
32
describe the structure of the greater sac
divided by transverse colon into supra colic and infra colic regions. supracolic- stomach, liver spleen
infracolic- small intestine, ascending and descending colon
33
what connects the greater and lesser sac
foramen of windsor
34
where is the hepatic renal recess
subhepatic space that separates the liver from the right kidney
35
where is the sub-diaphragmatic recesss
a potential space that lies between the right lobe of the liver and the inferior surface of the diaphragm.
36
where is the recto uterine pouch
pouch between uterus and rectum. pouch of Douglas- lowest point in abdo cavity
37
where is the rectovescical pouch
between rectum and bladder
38
where is the parabolic gutters, and what are their role
peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon, allow a passage for infectious fluids from different compartments of the abdomen.
39
what is the inguinal ligament formed from
thickened lower border of aponeurosis of EO muscle.
40
role inguinal ligament
support soft tissues in the groin area and anchor the abdomen and pelvis. connect oblique muscles to the pelvis
41
opening and exit to inguinal canal
opening- deep inguinal ring
| exit- superficial inguninal ring
42
how is the inguinal canal formed, and how can this cause hernias
it is the pathway that the testes are pulled down from the abdomen by the gubernaculum through. if processes vaginalis doesn't degenerate then you can get an indirect inguinal hernia (hydrocele)
43
boundaries of inguinal canal
Anterior wall – aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally.
Posterior wall – transversalis fascia.
Roof – transversalis fascia, internal oblique, and transversus abdominis.
Floor – inguinal ligament (a ‘rolled up’ portion of the external oblique aponeurosis), thickened medially by the lacunar ligament.
44
what is an indirect inguinal hernia
peritoneal sac enters through deep inguinal ring
45
what is a direct inguinal hernia
where the peritoneal sac enters the inguinal canal though the posterior wall of the inguinal canal.
46
what causes an indirect inguinal hernia
- failure of the processus vaginalis to regress.
- peritoneal sac and its contents may traverse the entire inguinal canal, emerge through the superficial inguinal ring, and reach the scrotum.
47
what causes direct inguinal hernia
- weakening in the abdominal musculature.
- peritoneal sac bulges into the inguinal canal via the posterior wall medial to the epigastric vessels and can enter the superficial inguinal ring.
48
compare indirect and direct inguinal hernias in relation to the inferior epigastric vessels
indirect- lateral
| direct- medial
49
borders of the hesselbachs triangle
Medial – lateral border of the rectus abdominis muscle.
Lateral – inferior epigastric vessels.
Inferior – inguinal ligament.
50
significance of hesselbachs triangle
potential weakness in abdo wall, direct herniation through
51
femoral canal boundaries
Medial border – lacunar ligament.
Lateral border – femoral vein.
Anterior border – inguinal ligament.
Posterior border – pectineal ligament, superior ramus of the pubic bone, and the pectineus muscle
52
how do inguinal hernias present
groin pain, bulge in inguinal canal area. if incarcerated there will be painful redness.
53
how do femoral hernias present
small lump in groin
54
when do femoral hernias occur
Femoral hernia occur when abdominal viscera or omentum passes through the femoral ring and into the potential space of the femoral canal.
55
umbilical hernia presentation
hernia at site of umbilicus, infant
56
para-umbilical hernia
acquired adult, through line alba region of umbilicus.
57
compare omphalocele vs gastroschisis
omphalocele- abdominal contents covered in peritoneum still, associated with other problems so higher mortality. through umbillical ring
gastroschisis- abdominal contents not covered in peritoneum, no other problems associated, paraumbilical
58
common locations for incisional hernias
midline, paramedium, gridiron, Pfannenstiel
59
different parts of stomach
going down: fundus, cardia (at superior opening), body, pylorus
60
sphincters stomach
Inferior Oesophageal Sphincter- allows food to pass from cardiac orifice to stomach, involuntary.
Pyloric Sphincter- exit of chyme/food from stomach.
61
arteries stomach
greater curvature- short gastric and R/L gastro-omental
lesser curvature- L/R gastric
pylorus- gastroduodenal
fundus and upper bodu- splenic artery(short and posterior gastric)
62
nerves stomach
PS- anterior and posterior vagus trunk
| S- T6-T9 spinal cord sements, passes to the coeliac plexus via the greater splanchnic nerve.
63
nerves stomach
PS- anterior and posterior vagus trunk
| S- T6-T9 spinal cord sements, passes to the coeliac plexus via the greater splanchnic nerve.
64
4 parts of duodenum
superior, descending, horizontal, ascending
65
blood supply duodenum
Superior (anterior, posterior) and inferior pancreaticoduodenal arteries
66
innervation duodenum
Celiac plexus, vagus nerve
67
describe superior part of duodenum
- intraperitoneal
- connects to liver via hepatoduodenal ligament
- ends at superior duodenal flexure
68
describe descending part of duodenum
- retroperitoneal
- ampulla of vater empties here
- ends at inferior duodenal flexure
69
describe horizontal duodenum
runs from right to left ventrally from the abdominal aorta and inferior vena cava.§
70
describe ascending duodenum
joins the intraperitoneally lying jejunum at the duodenojejunal flexure.
71
describe ascending duodenum
joins the intraperitoneally lying jejunum at the duodenojejunal flexure.
72
what are the two liver surfaces
diaphragmatic- anterior.
visceral- posterioinferior. covered with peritoneum
73
what are the four liver ligaments
falciform
coronary
triangular (R/L)-
lesser omentum
74
role falciform ligament
- connects anterior liver to abdominal wall
75
role triangular ligaments
- formed from union of coronary ligament's anterior and posterior layers at apex of liver
76
role coronary ligaments
- attaches superior liver to diaphragm
77
role lesser omentum
- attaches liver to lesser curve of stomach and duodenum. formed of hepatoduodenal ligament and hepatogastric ligament.
78
what are the three hepatic recesses
subphrenic (between diaphragm and anterior liver)
sub hepatic (under liver and above transverse colon)
morisons pouch (between visceral surface of liver and right kidney)
79
name fibrous layer covering liver
glissons capsule
80
lobes of liver
left and right, caudate at back top middle, quadrate at back bottom middle
81
where is the porta hepatic
between caudate and quadrate lobes. transmits neuromuscular bar hepatic veins
82
branches of celiac trunk
left gastric, splenic, common hepatic
83
branches of splenic artery
left gastroepiploic, short gastric, pancreatic brahcnes
84
branches common hepatic artery
proper hepatic and gastroduodenal
proper hepatic then gives rise to right gastric, R/L hepatic and cystic.
gasproduodenal then gives rise to right gastroepiploic and superior pancreatoduodenal
85
branches proper hepatic artery
right gastric
86
blood supply small intestines at L1
SMA
87
blood supply terminal ileum and caecum
ileocolic artery
88
blood supply jejunum and ileum
jejunal and ilieal arteries
89
blood supply ascending colon
right colic artery
90
blood supply transverse colon
middle colic
91
blood supply descending colon
left colic
92
blood supply sigmoid colon
sigmoidal
93
describe the inferior pancreatiduodenal artery
first branch of SMA. anastomoses with pancreatoduodenal artery to supply pancreas and duodenum
94
where does IMA arise
L3
95
3 branches IMA
left colic, sigmoid, superior rectal
96
structure small intestine
duodenum> jejunum> ileum
97
where does the jejunum begin
duodenojejunal flexure
98
where does the ileum end
ileocaecal junction
99
compare jejunum and ileum
- jejunum has thicker intestinal wall
- jejunum has longer vasa recta
- jejunum has less arcade
- jejunum is pink, ileum is red
100
blood supply duodenum
gastroduodenal (proximal) and inferior pancreatoduodenal (distal). shows change from foregut to midgut
101
blood supply jejunum and ileum
SMA. arcades form vasa recta
102
5 parts of pancreas
head, uncinate process, neck, body, tail
103
describe biliary tree
cystic duct from gall bladder joins common hepatic duct, forming common bile duct. pancreatic duct joins to form ampulla of vater
104
what are the portosystemic anastomoses
oesophagus- Left gastric veins (portal system) -> lower branches of oesophageal veins (systemic veins)
```
Umbilicus
Paraumbilical veins (portal) -> epigastric veins (systemic)
```
Upper part of anal canal
Superior rectal veins (portal) -> inferior and middle rectal veins (systemic)
105
function of portosystemic anastomoses
Provide alternative routes of venous blood circulation when there is a blockage in the liver or portal vein.
Ensure that venous blood from the gastrointestinal tract still reaches the heart through the inferior vena cava without going through the liver.
106
3 clinical signs of splenomegaly
ascites, splenomegaly, varices
107
biliary colic
CCK released, gallbladder contracts. gall stone pushed against neck of gallbladder, causing temporary obstruction and pain
108
acute cholecystitis
gall stone impacts in cystic duct. inflammation. murphys sign is positive.
109
acute cholangitis
infection of biliary tree, causes charcots triad- pain, inflammation, jaundice
110
Murphy's sign
place hand on abdomen, breathe in. gall bladder hits hand causing pain
111
charcots triad
pain, inflammation, jaundice
112
acute pancreatitis
stone in common bile after pancreatic duct joins. obstruction and blockage to bile and enzymes in pancreas. cause autodigestion.
113
what are different appendix locations
pelvic, subcecal, retroileal, retrocecal, ectopic, and preileal
114
what is raised ALT specific to
hepatocyte damage (HALT)
115
what is raised all phos/ALP linked to
biliary tree damage
116
what is raised amylase linked to
pancreatic problems
117
compare chrons and UC
chrons has granuloma, fistula and perianal disease. UC has mucosal inflammation, continuous inflammation and no perianal disease
118
where are parietal cells located
body
119
where are G cells located
pyloric antrum
